DATA MANAGEMENT CORE

了解不同医生、医生群体之间差异的原因和后果， 医院在提供医疗服务的效率方面，至关重要的是要有一个全面的 数据库具有足够的能力来描述医疗保健利用的详细模式，并能够 将这些文件链接到现在可从其他来源获得的补充数据，例如患者或提供者调查。 医疗保险索赔数据是这项任务的理想选择，因为有三个关键特征。首先，它们是全国性的， 范围：98%的老年人有资格享受医疗保险，因为几乎所有的医院和医生都提供 医疗保险登记者，数据可以提供洞察因素，影响医院的表现， 以及更普遍的医师实践。其次，索赔数据提供了详细的人口统计和财务数据， 信息，以及丰富的临床细节的具体服务提供给收费服务登记。第三、 通过适当的批准以保持机密性，可以使用单独的标识符获取数据， 可以支持跨文件、随时间以及到其他源的链接。这些数据在广泛的 医疗保健和经济研究已得到充分证明。 分析这些数据的复杂性和成本推动了此数据核心的特定目标： 1.为了维护和更新一个全面和安全的数据库的医疗保险登记档案，索赔 记录和补充文件。 2.获取和管理本计划项目资助所需的特定研究文件，并制定 特定于项目的分析文件。 3.为了维持能够管理大量患者可识别的计算基础设施和程序， 保密数据，同时确保及时和适当地接触授权调查人员。 4.使本计划/项目资助项下开发的研究文件可供研究使用 在法律允许的范围内。 提供给医疗保险受益人的具体服务的全面信息， 他们所接受的护理费用可以为提高医疗护理效率提供一个强有力的工具。的 这些数据库的机密性和个人性质要求它们以安全和 高效的数据中心，可以有效地管理它们，同时保护数据的完整性， 支持授权调查人员的需求。

To understand the causes and consequences of differences across physicians, physician groups, and hospitals in the efficiency with which they deliver medical care, it is crucial to have a comprehensive database with sufficient power to characterize detailed patterns of health care utilization and to be able to link those files to supplemental data now available from other sources such as patient or provider surveys. The Medicare claims data are ideal for this task because of three key features. First, they are national in scope: 98% of the elderly are eligible for Medicare, and because almost all hospitals and physicians provide care to Medicare enrollees, the data can provide insight into factors that influence both hospital performance and physician practice more generally. Second, the claims data provides detailed demographic and financial information, as well as rich clinical detail on the specific services provided to fee-for-service enrollees. Third, with appropriate approvals to preserve confidentiality, the data can be obtained with individual identifiers that can support linkage across files, over time, and to other sources. The utility of these data for a wide range of health care and economic research studies has been amply demonstrated. The complexity and costs of analyzing these data motivate the specific aims of this Data Core: 1. To maintain and update a comprehensive and secure database of Medicare enrollment files, claims records, and supplementary files. 2. To obtain and manage specific research files required for this Program Project Grant and to develop project-specific analytic files. 3. To maintain a computing infrastructure and procedures capable of managing a high volume of patientidentifiable, confidential data while ensuring timely and appropriate access to authorized investigators. 4. To make the research files developed under this program project grant available to the research community to the extent permissible under law. Comprehensive information on the specific services provided to Medicare beneficiaries and the quality and costs of the care they receive can provide a powerful tool for improving the efficiency of medical care. The confidential and personal nature of these databases mandates that they be maintained in a secure and efficient data center that can manage them effectively while protecting the integrity of the data and supporting the needs of authorized investigators.